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Coronary heart disease mortality after 5 years of adjuvant tamoxifen therapy: Results from a randomized trial
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
Department of Oncology, Södersjukhuset Hospital, Stockholm, Sweden.
Department of Oncology, Lund University Hospital, Lund, Sweden.
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2005 (English)In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 97, no 21, 1609-1610 p.Article in journal (Refereed) Published
Abstract [en]

From January 1, 1983, through December 31, 1992, a total of 4610 patients entered a randomized trial that compared mortality among patients receiving 2 years of adjuvant tamoxifen therapy with that in patients receiving 5 years of adjuvant tamoxifen therapy, 4175 of whom were recurrence free after 2 years of tamoxifen therapy. Among the 2046 patients randomly assigned to the 5-year group all-cause mortality, breast cancer-specific mortality, and the incidence of contralateral breast cancer were reduced, compared with those among 2129 patients randomized in the 2-year group, but the incidence of endometrial cancer was increased. In addition, mortality from coronary heart disease was statistically significantly reduced in the 5-year group, compared with that in the 2-year group (hazard ratio = 0.67, 95% confidence interval = 0.47 to 0.94, P = .022 [two-sided Wald test]). Ten years after surgery, 2.1% of the patients in the 5-year group and 3.5% of those in the 2-year group had died from coronary heart disease. No statistically significant increases in mortality from other heart diseases, cerebrovascular diseases, or other vascular diseases were observed. © The Author 2005. Published by Oxford University Press. All rights reserved.

Place, publisher, year, edition, pages
2005. Vol. 97, no 21, 1609-1610 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-31657DOI: 10.1093/jnci/dji342Local ID: 17468OAI: oai:DiVA.org:liu-31657DiVA: diva2:252480
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Long-term effects of adjuvant tamoxifen treatment on cardiovascular disease and cancer
Open this publication in new window or tab >>Long-term effects of adjuvant tamoxifen treatment on cardiovascular disease and cancer
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of this thesis were to investigate the long-term effects of adjuvant tamoxifen treatment on breast cancer recurrence and mortality, cardiovascular disease, and the incidence of secondary cancer.

Between 1982 and 1992, postmenopausal patients with early stage breast cancer were included in a randomized clinical study of 2 or 5 years of postoperative tamoxifen therapy. The trial was planned by the Swedish Breast Cancer Group, and it included 4610 patients. Follow-up on causes of death, hospitalizations and secondary cancers were obtained from national population-based registries. 

All-cause mortality, breast cancer-specific mortality and mortality from coronary heart disease were decreased in the 5-year group, but the incidence of endometrial cancer was increased (Paper I). The incidence and mortality of cerebrovascular diseases were increased during the active treatment phase, and reduced after the active treatment (Paper II). Similar results were seen for subgroups of cerebrovascular diseases such as stroke and ischemic stroke. In the 5-year group, the morbidity from coronary heart disease was reduced during treatment but not after treatment was stopped (Paper III). This was the case also for heart failure and for atrial fibrillation/flutter. For secondary cancers the lung cancer risk was reduced, as well as the lung cancer mortality (Paper IV). An increased risk was observed for endometrial cancer, but appeared to decrease over time. The risk of contralateral breast cancer was reduced, with most of the reduction after treatment was stopped. For distance recurrences the risk was reduced both during treatment and a few years after treatment was stopped. The breast cancer mortality was also reduced, especially during the post-treatment phase.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. 45 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1430
Keyword
Adjuvant, adverse events, breast cancer, cerebrovascular disease, coronary heart disease, heart failure, lung cancer, second primary cancer, tamoxifen
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-112085 (URN)10.3384/diss.diva-112085 (DOI)978-91-7519-182-9 (ISBN)
Public defence
2014-12-19, Eken, ingång 65, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2014-11-21 Created: 2014-11-13 Last updated: 2014-11-21Bibliographically approved

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Nordenskjöld, BoRosell, JohanCarstensen, John

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